THE NEW IWGDF GUIDELINES Nicolaas Schaper www iwgdfguidelines

THE NEW IWGDF GUIDELINES Nicolaas Schaper www. iwgdfguidelines. org

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org Plus: • Definitions and criteria • 10 systematic reviews >100 experts from >40 countries

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org IWGDF Sponsors Platinum sponsor: Gold sponsors: Silver sponsors: Bronze sponsors:

Sicco Bus Jaap van Netten Jan Apelqvist Robert Hinchliffe Benjamin Lipsky Nicolaas Schaper www. iwgdfguidelines. org

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org Conflict of interest statement • Production of the 2019 IWGDF Guidelines was supported by unrestricted grants from the following sponsors: Molnlycke Healthcare, Acelity, Conva. Tec, Urgo Medical, Edixomed, Klaveness, Reapplix, Podartis, Aurealis, Soft. Ox, Woundcare Circle, and Essity. • All individual conflict of interest statement of authors of this guideline can be found at: https: //iwgdfguidelines. org/aboutiwgdf-guidelines/biographies/ • Authors were not involved in discussions related to papers they co-authored

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org Malvern, 1996 Amsterdam, 1997

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 1999 2003 2007 2011 2015

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org Editorial board: 6 members Six working groups: 49 members External experts: 50 experts, from 40 countries, from 5 continents

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org GRADE methodology Guyatt et al, 2008; Alonso-Coelo et al, 2016

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 1: Formulate clinical questions • PICO format • • Patient Intervention (Comparison) Outcome • The question you ask determines the answer you get • Reviewed by external experts and editorial board

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 2: Outcome measures • Define: • Critically important outcomes • Important, but not critical, outcomes • Not important outcomes • Critically important: e. g. ulcer incidence, ulcer healing, amputation

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 3. Systematic review • Systematic reviews of the literature according to PRISMA • 10 systematic reviews

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 4. Formulate recommendations • Strength of recommendation (strong – weak) • • Quality of evidence Balance between benefits and harms Patient values and preferences Resource utilization • Quality of Evidence (high – moderate – low) • • Risk of bias of included studies Effect size Expert opinion Inconsistency, indirectness or imprecision not taken into account

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 4. Formulate recommendations In a person with diabetes and a foot ulcer, use the SINBAD system for communication among health professionals about the characteristics of the ulcer (Strong; Moderate)

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org 10 years full-time work 2 million Euros in in -kind contributions

Slides courtesy IWGDF; available at: www. iwgdfguidelines. org